Why Annual Reviews Matter
Seven things can change between plan years that directly affect your coverage and costs:
Drug Formularies
Medications can be added, removed, or moved to different cost tiers — changing what you pay at the pharmacy.
Provider Networks
Doctors and hospitals can enter or leave your plan’s network, affecting your access and costs.
Monthly Premiums
Your plan’s premium can increase or decrease from one year to the next.
Copays & Coinsurance
The amounts you pay for office visits, procedures, and prescriptions can change.
Plan Benefits
Extra benefits like dental, vision, hearing, and fitness programs may be added, reduced, or eliminated.
Preferred Pharmacy Networks
Your pharmacy may no longer be in-network or preferred, meaning higher costs for the same medications.
Star Ratings
A plan’s quality rating affects available bonus benefits and can signal declining service or coverage quality.
When You Can Make Changes
Annual Enrollment Period (AEP)
October 15 – December 7
- Switch from one Medicare Advantage plan to another
- Join or drop a Part D prescription drug plan
- Switch from Medicare Advantage back to Original Medicare
- Switch from Original Medicare to Medicare Advantage
Medicare Advantage Open Enrollment (OEP)
January 1 – March 31
- Switch from one Medicare Advantage plan to another
- Drop Medicare Advantage and return to Original Medicare + Part D
- Cannot be used to join Medicare Advantage for the first time
How Our Annual Review Works
- Review Your Current Coverage: We look at your medications, doctors, how satisfied you are with your current plan, and any issues you’ve experienced.
- Compare Every Option in Your County: Your plan is compared side-by-side against every available option in your area — premiums, copays, formularies, and networks.
- Recommend Only What Benefits You: If your current plan is still the best fit, we tell you. If a better option exists, we show you exactly why and handle the switch.
2026 Medicare Costs at a Glance
| Part B Premium | $202.90/month |
| Part B Deductible | $283/year |
| Part A Deductible | $1,736 per benefit period |
| Part D Max Deductible | $615 |
| Part D Out-of-Pocket Cap | $2,100 (Inflation Reduction Act) |
| High-Deductible Plan G Deductible | $2,950 |
Source: Centers for Medicare & Medicaid Services (CMS), 2026 figures.
Frequently Asked Questions
When is the Annual Enrollment Period?
October 15 – December 7 each year. Changes take effect January 1.
Can I switch from Medicare Advantage to Original Medicare?
Yes, during the AEP (Oct 15 – Dec 7). You can also switch during the OEP (Jan 1 – Mar 31).
Does it cost anything for a plan review?
No. Independent brokers are compensated by insurance carriers if you enroll. There is no cost to you for the review itself.
How do I know if my plan’s formulary changed?
Your plan is required to send you an Annual Notice of Change (ANOC) by September 30 each year. Our team can also review this with you.
What if I’m happy with my current plan?
That’s great — but plans change their benefits every year. A quick review confirms you’re still in the best option, or gives you peace of mind that no changes are needed.
What is the Part D out-of-pocket cap?
Starting in 2025, the Inflation Reduction Act caps Part D out-of-pocket costs. For 2026, the cap is $2,100 per year. Once you reach this amount, you pay $0 for covered drugs the rest of the year.